IMPACT PHYSICAL THERAPY LLC (NPI# 1699159723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699159723 |
| Entity Type | Organization |
| Organization Name | IMPACT PHYSICAL THERAPY LLC |
| Other Organization Name | IMPACT PHYSICAL THERAPY |
| Practice Address |
96 Yellow Creek Road Evanston WY 82930 |
| Practice Telephone | 3074444466 |
| Practice Fax Number | 3074444468 |
| Mailing Telephone | 3074444466 |
| Mailing Fax Number | 3074444468 |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2017-02-13 |
| Authorized Official Name | JUSTIN DENNIS (OWNER) |
| Authorized Official Telephone | 8012094466 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT 1683 | WY | Ambulatory Health Care Facilities |
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT1568 | WY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Impact Physical Therapy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386109668 | Impact Physical Therapy LLC | Physical Therapist | 7295 Sparta Pike, Watertown, TN 37184 | 2019-01-31 |
| 1487885554 | Impact Physical Therapy LLC | Specialist | 5415 W Lake Rd, Erie, PA 16505-2841 | 2009-08-06 |
| 1215319413 | Impact Physical Therapy LLC | Physical Therapist | 19420 N 59th Ave, Ste E500, Glendale, AZ 85308-6817 | 2015-06-24 |
| 1447425103 | Impact Physical Therapy LLC | Physical Therapist | 5431 Edmondson Pike, Suite 20, Nashville, TN 37211-5806 | 2008-04-24 |
| Street Address |
96 YELLOW CREEK ROAD |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| 1568766889 | Tiffany Lynn Pieger | Massage Therapist | 116 10th Street, Evanston, WY 82930 | 2010-12-29 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750612115 | Northwestern University Intercollegiate Sports Medicine | Clinic/Center | 2703 Ashland Ave, Northwestern University Sports Medicine, Evanston, IL 60208-0001 | 2010-01-26 |
| 1598942971 | Elizabeth Hart, M.p.t. & Associates, P.C. | Clinic/Center | 1618 Orrington Ave Ste 322, Evanston, IL 60201-5060 | 2008-01-28 |
| 1780157438 | Integrated Physical Therapy and Yoga LLC | Clinic/Center | 1818 Dempster St, Evanston, IL 60202-1003 | 2019-01-05 |
| 1982877718 | Rehabilitation Networks Inc. | Clinic/Center | 1713 Central St, Evanston, IL 60201-1507 | 2008-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255943098 | Jackson Hole Sports Recovery LLC | Clinic/Center | 680 S Cache St Ste 100, Jackson, WY 83001-8694 | 2020-08-22 |
| 1093136038 | North Star Physical Therapy, LLC | Clinic/Center | 1403 W. Ramshorn, Dubois, WY 82513 | 2013-12-18 |
| 1265861884 | Active Aging and Rehabilitation Partners, LLC | Clinic/Center | 215 Walterscheid Blvd, Apt F305, Cheyenne, WY 82007-2333 | 2013-11-04 |
| 1922444744 | Valley Physical Therapy LLC | Clinic/Center | 1210 River Street, Saratoga, WY 82331 | 2013-05-20 |
| 1699007658 | Andrea Marie Dillon | Clinic/Center | 120 West Pearl Avenue, Jackson, WY 83001 | 2010-02-02 |
| 1821222548 | Developmental Physical Therapy Services, LLC | Clinic/Center | 1355 Hoyt Ln, Jackson, WY 83001-9446 | 2009-05-09 |
| 1972780187 | Advanced Physical Therapy, LLC | Clinic/Center | 207 E Holly, Saratoga, WY 82331 | 2008-01-30 |
| 1912052242 | Blair Investments Inc | Clinic/Center | 1331 Prairie Ave Ste 6, Cheyenne, WY 82009-4867 | 2007-01-25 |
| 1740209956 | Therapy Solutions, Inc. | Clinic/Center | 6631 E 2nd St, Casper, WY 82609-4355 | 2006-07-19 |
| 1336188796 | High Plains Physical Therapy Limited Partnership | Clinic/Center | 2241 Foothill Blvd, Suite 602, Rock Springs, WY 82901-5698 | 2006-06-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.